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A therapeutic centre of excellence 

We deliver excellent therapeutic services and promote recovery, resilience and specialist tailored psychological education throughout all our therapeutic sessions. Feeling safe is an integral part of healing, therefore we ensure our clients connect with a sense of internal and external safety which goes beyond the therapeutic environment. 
Treating Trauma and PTSD is achieved with a systematic, evidenced-based approach. The therapist should be trained in at least five Trauma Protocols in order to effectively treat complex trauma and PTSD. 
Non Trauma-Focused Psychotherapy models and mindfulness are evidenced as contraindicated for treating trauma. 
There are three stages to effectively treat trauma. The stages are used for Type I and Type II yet the content of each stage differs depending upon the client's needs and the complexity of the trauma - outlined below. 

PTSD Type I Trauma (Following a single incident) 

Phase one: Safety and stabilisation (symptom management, improving emotional regulation and addressing current stressors). 
 
Phase one focuses on the safety and stabilisation, dealing with 'issues of personal safety and development of self and ego capacities (i.e. tolerating and modulating strong emotions)'. This initial phase focuses on the client's inner experiences, addressing memories, emotions and sensations including flashbacks. 
Phase two: Trauma processing (focused processing of traumatic memories). 
 
Evidence-based treatments such as Prolonged Exposure Therapy (PET) and trauma-focused CBT have been recommended by NICE guidelines for the second phase of treatment. 
Phase three: Reintegration (re-establishing social and cultural connection and addressing personal quality of life). 
 
Phase 3 focuses on increasing self esteem, self respect, increasing healthy connections and exploring and integrating one's sense of identity. 
 
This phase is as important as the other two and gives an opportunity to re-evaluate current triggers and anticipatory fears towards change. 
Success of the phases are measured throughout by assessing if the client has the ability to effectively cope with previous triggers and move towards the desired goals of everyday life. 

Complex PTSD Type II Trauma (Following ongoing multiple incidents) 

Phase one: Safety and stabilisation (symptom management, improving emotion regulation and addressing current stressors) 
Phase one focuses on the safety and stabilisation, dealing with 'issues of personal safety and development of self and ego capacities (i.e., tolerating and modulating strong emotions)'. This initial phase focuses on the client's inner experiences, addressing memories, emotions and sensations including flashbacks. 
 
We will aim to reduce self injurious behaviour, addictions, pathological dissociation and extreme emotion dysregulation, with the aim of creating internal and external safety to disengage the ‘emergency’ brain (limbic system) and to activate the thinking brain (prefrontal cortex). 
It is important to reduce any co-morbid issues and reduce all trauma related dysregulation to improve functioning and further preparation for trauma processing. These approaches are aimed at tackling the maladaptive defences so clients can increase affect tolerance without becoming overwhelmed. 
 
Cloitres Skills Training in Affect and Interpersonal Training (STAIR) has been recommended as a model that “integrates all that we have come to understand about the unique needs of individuals with complex PTSD and/or post traumatic dysregulation”. 
Phase two: Trauma processing (focused processing of traumatic memories) 
Evidence-based treatments such as Prolonged Exposure Therapy and trauma-focused CBT have been recommended by NICE guidelines for the second phase of treatment. However, there is not one treatment recommended over another for cPTSD. 
 
CBT, CPT and PET have a similar approach, functioning from a top down process (driven by the neocortex not the limbic system), yet PET has an extra component of exposing the client to the stimulant. EMDR phases, relative to processing, are phase 3 through to 8 reprocessing trauma at the neurophysiological level by focusing on both executive functioning and the limbic system (emotional brain). 
IRRT is a model designed specifically for sexual abuse victims. IRRT aims to reduce PTSD symptoms and traumagenic schemas of survivors of sexual abuse. “To achieve this it combines imaginal exposure, mastery imagery, self nurturing imagery and cognitive reprocessing, which are designed to go beyond extinction models in order to alter recurring traumatic images, create adaptive schemas and enhance the clients capacity for self nurturance” (Smacker & Gonzalez). 
Each of these phases need to occur for successful emotional processing. This bottom up process incorporates socratic questioning during the imagery re-scripting, which helps the client to identify, challenge and modify maladaptive beliefs tied to the trauma whilst empowering them to take mastery of the imagery.  
 
Rescripting helps change the traumatic memory with an emphasis on positive, corrective cognitive changes to previous negative secondary beliefs and pathogenic schemas. 
Phase three: Reintegration (re - establishing social and cultural connection and addressing personal quality of life) 
Phase 3 focuses on increasing self esteem, self respect, increasing healthy connections and exploring and integrating a sense of identity. 
This phase is as important as the other two and gives opportunity to re-evaluate current triggers and anticipatory fears towards change. 
Success of the phases is measured throughout by assessing if the client has the ability to effectively cope with previous triggers and move towards the desired goals of everyday life. 
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